PURPOSE: To evaluate the causes of failed dacryocystorhinostomy (DCR) and the effects of transcanalicular diode laser-assisted endonasal revision surgery according to the number of silicone tubes. METHODS: Sixty-seven patients (70 eyes) who underwent revision surgery using transcanalicular diode laser for failed primary endonasal DCR at Sungmo Eye Hospital between March 2007 and December 2012 were studied retrospectively. The causes of failed DCR and the time of recurrence were evaluated. The revision surgeries were endoscopic removal of granuloma and membrane and synechiolysis with intubation of 1 or 2 silicone tubes. We compared the results of revision surgery with 1 silicone tube and 2 silicone tube intubations. RESULTS: Recurrence occurred after a mean duration of 4.6 months following the first DCR. The causes of surgical failure were granuloma (35 eyes), membranous obstruction (23 eyes), synechia (7 eyes), and functional obstruction (5 eyes). We performed revision surgery with 1 silicone tube intubation in 45 eyes (group A) and 2 silicone tube intubations in 25 eyes (group B). The final success rates in groups A and B were 75.6% (34/45) and 84% (21/25), respectively (chi-square test, p = 0.828). CONCLUSIONS: Transcanalicular diode laser-assisted endonasal revision surgery with 2 silicone tubes is not recommended.
Dacryocystorhinostomy ; Granuloma ; Humans ; Intubation ; Lasers, Semiconductor ; Membranes ; Recurrence ; Retrospective Studies ; Silicones*

PURPOSE: To compare the effect of femtosecond laser-assisted cataract surgery with conventional cataract surgery on effective phacoemulsification time (EPT). METHODS: This study included 66 patients 100 eyes who underwent femtosecond laser-assisted cataract surgery and 68 patients 100 eyes who underwent conventional cataract surgery. Both groups underwent phacoemulsification using pulsed ultrasound energy and EPT was evaluated. The groups were further analyzed according to preoperative Lens opacities classification system (LOCS) III grading. Patients who had femtosecond laser-assisted cataract surgery underwent lens fragmentation with quadrant, hybrid, or grid pattern and the EPT was respectively evaluated. RESULTS: The mean EPT was 5.85 +/- 4.31 seconds in the femtosecond laser-assisted cataract surgery group and 10.34 +/- 6.61 seconds in the conventional group. Overall, EPT was statistically significantly lower in the femtosecond laser-assisted cataract surgery group compared to the conventional group. When the groups were analyzed according to LOCS III grading, this result was consistent for all cataract grades and the reduction in EPT was increased with the higher LOCS III grade. When the groups were analyzed according to lens fragmentation patterns, the mean EPT was lower with 350 microm grid pattern than the quadrant or hybrid pattern. CONCLUSIONS: The femtosecond laser-assisted system in cataract surgery can be an efficient cataract surgery using lower EPT compared to the conventional procedure. Additionally, significant differences were observed in the mean EPT of cataract surgery using the femtosecond laser-assisted system among the 3 lens fragmentation pattern groups.
Cataract* ; Classification ; Humans ; Phacoemulsification* ; Ultrasonography

PURPOSE: Glutamate and aspartate are the excitatory amino acid neurotransmitters and NMDA (N-methyl-D-aspartate) is one of their major receptors. NMDA agonist may sti mulate serotonergic nervous system that inhibit the penile erection as well as induce the penile erection. We investigate the effects of NMDA agonist on serotonin release from hippocampus. MATERIALS AND METHODS: The slices of hippocampus were incubated in a buffer con taining 0.1mM [(3)H]5-hydroxytryptamine (5-HT) for uptake in the male rat. The release of 5-HT into the buffer during each 10 minutes period was measured and the radio activities in each buffer and the tissue were counted. After 50 min from the initiation, NMDA agonist were administered at 6th and 7th 10 min period respectively. The changes of 5-HT release were expressed as percent values compared to the 5th 10 min period. Tetrodotoxin was used to determine the possible involvement of interneuron on the action of these neurotransmitters. RESULTS: A steady release of 5-HT was observed up to 100 minutes after the rapid release during the first 40 minutes. Treatment of tetrodotoxin (10(-6)M) did not change the spontaneous release of 5-HT. The 5-HT released during 10 and 20 minutes of NMDA agonist (10(-4M)) treatment significantly higher than those of control group. The increase of 5-HT release by NMDA agonist was blocked by pretreatment with tetro dotoxin. The release of 5-HT was increased by NMDA agonist and this response was blocked by tetrodotoxin. CONCLUSIONS: NMDA agonist increases the release of 5-HT through the activation of the interneurons and these results suggest that NMDA agonist may stimulate the serotonergic nervous system that inhibit the penile erection as well as inducing the penile erection.
Animals ; Aspartic Acid ; Excitatory Amino Acids ; Glutamic Acid ; Hippocampus* ; Humans ; Interneurons ; Male ; N-Methylaspartate* ; Nervous System ; Neurotransmitter Agents ; Penile Erection ; Rats* ; Serotonin* ; Tetrodotoxin

Lipoblastoma is a benign tumor which frequently arises in the limbs but rarely in the mediastinum, and is common in children under the age of three years. We report a case of mediastinal lipoblastoma in a 27-month-old female child complaining of dyspnea. Plain radiography demonstrated a huge well-defined mass in the me-diastinum, while CT scanning revealed a soft tissue mass with an internal hypodense portion. When radi-ographic images in children under the age of three reveal a soft tissue mass with a fat component in the mediastinum, especially where there is no calcification or a cystic component, lipoblastoma should be included in the differential diagnosis.
Child* ; Child, Preschool ; Diagnosis, Differential ; Dyspnea ; Extremities ; Female ; Humans ; Lipoblastoma* ; Mediastinum ; Radiography ; Tomography, X-Ray Computed

No abstract available.
Bacteria, Anaerobic*

Tetanus is a rare disease in the developed countries, including Korea, as a result of nearly universal active immunization. Because many physicians have little experience with its diagnosis and management, misdiagnosis and therapeutic delay may result in catastrophic consequences. We report one case of generalized tetanus. A previously healthy 35-year-old man was admitted to the emergency department because of stiffness on jaw and neck. board-like abdomen, extended and rigid both legs, chest tightness, and dyspnea. Seven days before admission, he was injured on the right thing at work. In the emergency department, he was given 5,000 units of human tetanus immunoglobulin intramuscularly, as well as diazepam 2 mg/hr intravenously. On the second hospital day, tracheostomy was performed. Ten days later, his condition was improved. Twenty eight days after admission, he was discharged without any complication.
Abdomen ; Adult ; Developed Countries ; Diagnosis ; Diagnostic Errors ; Diazepam ; Dyspnea ; Emergency Service, Hospital ; Humans ; Immunoglobulins ; Jaw ; Korea ; Leg ; Neck ; Rare Diseases ; Tetanus* ; Thorax ; Tracheostomy ; Vaccination

Bethanechol, a cholinergic agonist, has been recommended for the management of peripheral anticholinergic side effects during the treatment of antipsychotic medications. But there have been few studies which have evaluated the drug interactions of antipsychotics and bethanechol, even the treatment effects of bethanechol on anticholinergic side effects. So the authors have evaluated whether psychopathology and plasma haloperidol and reduced haloperidol concentrations are significantly changed or not when bethanechol was administrated with maintained doses of haloperidol and other coadministrated drugs(such a benztropine). Also we have evaluated the abating effects of bethanechol on anticholinergic side effects during the treatment with haloperidol. Fifteen schizophrenics with higher than 5 of total score of anticholinergic side effects of 'Rating scale for side effect' were assigned to two groups, and bethanechol 30mg/day and 60mg/day were applied on each group for 4 weeks. The daily haloperidol dosages were fixed before 2 weeks of study. We assessed anticholinergic side effects by 'Rating scale for side effect' and psychopathology by BPRS, and plasma haloperidol and reduced haloperidol concentrations by HPLC at baseline, 2nd week and 4th week. The results were as followed. 1) There was no significant change of plasma haloperidol and reduced haloperidol concentration. 2) At baseline, the dosage of haloperidol showed significant correlation with the total score of anticholinergic side effect, but not at 2nd week and 4th week. 3) In 60mg/day group, dry mouth and the total score of anticholinergic side effects were significantly improved, but not in 30mg/day group. 4) There was no significant change of BPRS except withdrawal at 2nd week. These results suggest that coadministration of bethanechol influenced neither on psychopathology nor on plasma haloperidol and reduced haloperidol concentrations and that improved dry mouth and total score of anticholinergic side effects at 60mg/day.
Antipsychotic Agents ; Bethanechol* ; Cholinergic Agonists ; Chromatography, High Pressure Liquid ; Drug Interactions ; Haloperidol* ; Mouth ; Plasma* ; Psychopathology ; Schizophrenia

No abstract available.
Animals ; Burns* ; Lymphocyte Subsets* ; Lymphocytes* ; Mice* ; Spleen* ; Thymus Gland*

PURPOSE: To compare the characteristics of optical coherence tomography in eyes with treatment-naïve typical neovascular age-related macular degeneration (typical nAMD), polypoidal choroidal vasculopathy (PCV), and retinal angiomatous proliferation (RAP). METHODS: One hundred fifty-three eyes newly diagnosed with exudative AMD were retrospectively collected. All study eyes were classified into three subtypes: typical nAMD, PCV, and RAP. Subfoveal choroidal thickness (SFCT) was measured using enhanced depth imaging optical coherence tomography (EDI-OCT). Central macular thickness (CMT) and other OCT features including intraretinal cystoid fluid and subretinal fluid were also evaluated in all eyes. SFCT, CMT and other OCT features were compared among the three subtypes of exudative AMD. RESULTS: Seventy-four eyes with typical nAMD, 55 eyes with PCV, and 24 eyes with RAP were included. SFCT was significantly thickest in PCV and thinnest in RAP (p < 0.001). RAP showed the thickest CMT and the highest frequency of intraretinal cystoid fluid (p = 0.004, p < 0.001, respectively). CONCLUSIONS: In patients with exudative AMD, different characteristics of OCT were observed according to the three subtypes. Identification of OCT characteristics could help differentiate the subtypes of exudative AMD.
Choroid ; Humans ; Macular Degeneration* ; Retinaldehyde ; Retrospective Studies ; Subretinal Fluid ; Tomography, Optical Coherence*

PURPOSE: It is known that alpha-2 receptor is found at the presynaptic serotonergic nervous system and a consequence of increased activation of alpha-2 receptor decreases the serotonin release. So Alpha-2 blockers may have the effect on the release of serotonin. The major serotonergic innervation is found at the hippocampus. This study was performed to investigate the effect of the alpha-2 receptor blocker to serotonin release in rat hippocampus. MATERIALS AND METHODS: The hippocampus from the male rat brain was sliced. After 30 minutes preincubation in the normal buffer, the slices were incubated for 20 minutes in a buffer containing 0.1 microM[3H]5-HT for uptake, and washed. After administration of alpha 2 receptor blockers, yohimbine (10-5M), the release of [3H]5-HT into the buffer was measured, the radioactivities in each buffer and the tissue were counted and the results were expressed as a percentage of the total activity. The value of released [3H]5-HT was expressed as percent of the value at 50 minutes when a steady state of [3H]5-HT release was obtained. RESULTS: After adminstration of yohimbine (10-5M), the values(mean+/-SE, %) were 147.5+/-9.2 at 60 minutes and 143.8+/-7.3 at 70 minutes compared to the values of control group, 96.6+/-1.9 at 60 minutes and 89.6+/-2.3 at 70 minutes. The release was increased significantly after adminstration of yohimbine. CONCLUSIONS: Alpha-2 receptor blockers increased the release of serotonin. It is suggested that the consideration of the increase of serotonin release by alpha-2 receptor blockers may be helpful to understand the effect of serotonin on sexual function.
Animals ; Brain ; Hippocampus ; Humans ; Male ; Nervous System ; Radioactivity ; Rats* ; Serotonin* ; Yohimbine